Inpatient Pediatric Ophthalmology Consults at a Tertiary Care Children’s Hospital

Abstract

 

Purpose

 

Pediatric ophthalmology consultation is requested to diagnose and treat a variety of conditions in tertiary care children’s hospitals. The goals of this study were to review inpatient consultations performed at a tertiary care children’s hospital and to compare the frequency, type, and results of previously described adult inpatient consults to those of pediatric inpatient consults.

 

Methods

 

Health records of inpatients seen by the ophthalmology service at Lurie Children’s Hospital between July 1, 2013 and June 30, 2014 were retrospectively reviewed. Reason for consultation, ophthalmic diagnosis, medical diagnosis, service requesting consultation, and ophthalmologic interventions were recorded. A two-sample test was used to compare pediatric consults to adult inpatient consults seen at Northwestern Memorial Hospital. P-values < 0.05 were considered significant.

 

Results

 

426 new inpatient consultations were requested from the pediatric ophthalmology service. The most common reasons for consultations were to evaluate for papilledema (24.12%), to participate in the work-up of an unknown systemic disease (11.0%), to evaluate for non-accidental trauma (7.96%), and to evaluate eye redness (5.15%). Intracranial mass lesions (10.65%) and hydrocephalus (7.79%) were the most frequent primary medical diagnoses. The most common ophthalmology diagnoses were optic disc edema (6.56%), orbital or preseptal cellulitis (4.46%), and retinal hemorrhages (2.58%).<br /> <br /> Blurred vision was a more common reason for consultation in the adult population than pediatric population (14.8% vs 3.5%, p < 0.0001). Evaluation for papilledema was a more common reason for consultation in the pediatric population (24.1% vs 3.3%, p<0.001). Optic disc edema was found more often in children than adults (6.56% vs 1.5%, p< 0.0001). Regarding the primary medical diagnoses, the pediatric population had more trauma (5.71% vs 1.5%) and hydrocephalus (7.79% vs 1%) than the adult population (p<0.0001 for both).

 

Conclusions

 

Pediatric inpatient ophthalmology consultations address a variety of pathologies. Our results demonstrate differences between the characteristics of consultations at a tertiary adult hospital compared to a tertiary children’s hospital. Physicians at teaching hospitals can incorporate this data to optimize patient care and to improve the training curriculum for ophthalmology and non-ophthalmology housestaff.